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Episode 51: 24/7 Breastfeeding Support with Melanie Silverman, MS, RD, IBCLC

, July 14, 2021

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Jacqueline Kincer  0:37

Welcome back to The Breastfeeding Talk Podcast. I’m Jacqueline Kincer, your host, and today I have an exciting guest, Melanie Silverman, she is an IBCLC. And she is the Chief Clinical Officer at pacify. And that’s enough of an intro for me. I would really love for you, Melanie to tell our listeners, what is pacify? And what’s your role there, because I think you’ll do a much better job of explaining it than I will.


Melanie Silverman  1:09

Well, first, thank you so much for having me, I really am happy to be here. I think what you’re doing for the breastfeeding community is really, really important. And, you know, we’re all trying to kind of work together to support parents wherever they are in their feeding journey. So thank you for having me. Anytime someone gives me an opportunity to talk about pacify I take it because I’ve been very excited about this from the moment that it landed in my lap in 2014. And so what a pacifier is, in a nutshell, is an app. And so New parents download the app to their phones, they press a button, there’s many buttons, but we’re specifically talking about the lactation button today, they press a button and they get connected with a lactation consultant and international board certified lactation consultant in oftentimes less than a minute or a couple minutes, and they get the help they need the moment that they need it. And the neat thing about it is that pacify is available 24/7 365. So yes, we get calls on Christmas, New Years, you know, July 4, because as you know, babies are very disrespectful to normal business hours. And so they cry at three in the morning on Saturdays, and so pacifies available for those situations. And then my job actually at pacify is as the Chief Clinical Officer. And so I recruit, hire and manage all the lactation consultants that staff the app. And so it’s very joyful because I get to choose from the 60,000 we have the United States some of the best of the best to really love their jobs and want to take on the job that they have it pacify. Oh,


Jacqueline Kincer  2:53

I love that. Thank you so much for that intro. And yeah, for anyone who was starting out listening to this, they’re not a pacifier company. So I had someone asked me that one time they were like pacify, I haven’t heard of that brand. And I was like, oh, no, it’s an app. Which is so cool. And and we’ll get into kind of you know, who works with you and offers that support. But just so the listeners know, like, you know, Melanie’s company, Melanie has not like paid me to come on here. This is not some sort of sponsored podcast episode, I invited Melanie on the episode because she offers something that I can’t. I’m a solo practice over here. And I am not going to log on with you at midnight, when you have some questions or Christmas, I do have normal business hours. So I love that Melanie fills that gap that so many of us who you know are in private practice cannot. And then she incorporates people who are doing their own thing. And then they can also be a part of a pacifier, bring that experience in there with them. So just so you guys know, I really wanted Millie to come on and talk about this because it’s just an underutilized method of getting lactation and breastfeeding support. And I just love this concept. Because Melanie, you’re an IBCLC yourself. So I’d actually love to hear more about how you became an IBCLC. And what your journey has been like with that.


Melanie Silverman  4:23

I’d love to tell that. And I think, you know, I love so much of what you said, I think you know, wherever anybody is in the breastfeeding space. I think we’re all trying to I what I really try to emphasize when I’m talking to the lactation consultant who work for pacifier, people who want to work for pacifier or just the breastfeeding community is you know, we all are working towards the same goal. And I think all of us believe I know you do that, like the moment that a person has a question about breastfeeding, they should get the answers and that helps to help initiate breastfeeding, extend breastfeeding and so it’s a very joyful field to work in and pacify. been a real blessing. But I actually, I’m a registered dietician as well. And I just grew up in Columbus, Ohio, even though I live in California now, so I’m, I’m a Midwestern girl.


Melanie Silverman  5:10

And I was born in Columbus.


Melanie Silverman  5:12

No, you were not. Yes,


Melanie Silverman  5:14

I was. You were not. I was. How cool? Can I know the city? No, I was born in Columbus. It used to be called Riverside Methodist Hospital, but no, forget what it’s called.


Melanie Silverman  5:26

Sure. So yeah, so I grew up in Bexley. Okay, then Columbus, like about, like, 15,000 kids. And yeah, so I have like a, you know, since I’ve left, I live in California now. But since I’ve left Ohio, I have such a love for the Midwest and for Ohio, where I grew up and such more of an appreciation because I think I’ve matured a bit. And so I really, that’s so neat, that that we share that. But um, so I grew up in Columbus, I went to Indiana University and then moved to Chicago, which is about the best place one of the best cities in the United States to train as a medical healthcare professional. And so I, I went there, got a job, and really had some trouble in college, you know, figuring out what I wanted to do, I was pre med and then decided to actually after graduating not to go to medical school and decided to go back to become a dietitian. So I went to Loyola University, I got a job at a hospital, you know, doing those diets, like, you know, people can’t chew, they have to have a mechanical soft diet. So I learned about those and soft diets and low salt diets and low fat diets at the time. We can talk about that another time. But these were the kind of things that were happening in the 90s. Okay, and so I learned about that, and completed dietetic requirements. And then I headed over to Rush University for my master’s degree in clinical nutrition. And at the time, Oprah was a very big force in Chicago, her show was, you know, worldwide, I watched it, I was a faithful follower. And I swore that I wanted to do adult weight loss, like all I wanted to do was solve the obesity crisis in the United States. And so I, my goal was to be on the show to work to do B or like dietitian consultant on her show. And that didn’t work out, as you can tell. I got a job at the University of Chicago, and was supposed to work in cardiology and thought it would be perfect. And the first day they said, Hey, Melanie, you’re not going to work cardiology, we’re going to put you in the pediatric Burn Unit. And all the ICU, so you’re not going to talk to any patients, you’re going to talk to physicians. And I was really, you know, it was a, I was in my 20s I had been through so much school already. I was very, like nervous. Because I didn’t even know how to really take care of my sunburns. How was I going to take care of burn children in an intensive care unit. And so I was fortunate enough to to work with a plastic surgeon named Larry Gottlieb who kind of took me under his wing and taught me everything I know about ICU nutrition and pediatrics, and I learned about pediatric through burns children. And then what happened was my managers kept saying, Oh, my gosh, well, you know, pediatrics, you should move to the pediatric ICU. So I stayed in the burn unit, but peeled off adult levels, you know, adult layers and then move to the pediatric ICU, then eventually ended up in the NICU. And as you know, in a needed neonatal ICU situation. There’s, it’s like a whole new world. And I hope that people listening that you never experienced a NICU. But if you have experienced in NICU, my heart goes out to you, because it’s a really scary environment. The babies are very small, you know, we’re talking, you know, some of them are, you know, born at 2324 weeks. And it’s can be very shocking and traumatizing. But when I landed in there at the University of Chicago, I saw all these formulas, and I had to learn all these formulas. And I was so confused. And I kept reading about and they kept saying, when breast milk is not available, use this formula. And I kept thinking, why isn’t breast milk available? This is crazy. It just started learning and learning and learning and thought, Oh, my God, I’m a dietitian and pediatrics and I really need to learn about breastfeeding. And so I found IBCLC registered nurses were amazing, who trained me for several years to come and I CLC. And then I started a private practice. And then that’s kind of how I became an IBCLC is just really through pediatric burns.


Jacqueline Kincer  9:19

Wow, that’s such a unique journey. And I think the cool thing about IBCLCs is that we all do come from various backgrounds, life experiences that led us down this path, and we bring so much to the table when we have this varied experience. It’s not like, you know, you go to college and you’re just like, Okay, I’m gonna become a doctor. So I go to medical school, there’s usually some sort of passion that’s ignited us to do what we do. And I always tell people, I didn’t grow up thinking I wanted to be a lactation consultant. I didn’t even know that was a thing. So you know, I just think that’s so cool that you did that. And I love that you have that pediatric Nutrition experience it, you have so much to give in this field and with what you’re doing over it pacify, which is awesome. And I know one of the things that you had mentioned before we got on here today was that you wanted to talk about, you know, how, why is what we do and what you do so important, you know, because it’s, like you said, Why isn’t breast milk available? Why is that even a question that we we are asking? So I’d love for you to talk a bit more about that importance of, you know, the health for the parents the health for the babies, and accessibility as well.


Melanie Silverman  10:40

Yeah, well, pacify was born because of lack of accessibility. Right. And so pacify was started by two men, actually, who were noticing that women were going to the ER, for breastfeeding assistance. And so they got in touch with me and said, Why is this happening? And I was able to explain to them that it’s lack of access, because as you and I both know, you know, it’s, it’s difficult to find lactation consulting, the minute you need it, it also is difficult to find somebody good. It doesn’t it’s like finding somebody, but then finding somebody good is really tough. And so pacifier was really born to provide more access. Everybody has smartphones, right? Over 90% of people have smartphones, the United States. And so it was born out of trying to provide access. Okay, so that’s one part of the issue with breastfeeding is getting the help when you need it. Okay. The second issue, I believe, is, you know, I spend a lot of time trying to support parents to trust their bodies. I don’t know what has happened in the last maybe 5060 100 years. But there seems to be a distrust of our bodies, like, how’s the smoke going to happen? How is this all going to work, and also really surrendering to this baby eight to 12 times a day, it is not that much fun. Let’s be honest. In the beginning, it’s hard. And so I think that this kind of worry about, you know, we get a lot of calls about milk supply. Do I have enough? Am I making enough? Am I okay, we get those calls, that’s really, a lot of what pacify does is reassurance from an expert, that everything is okay. But people have a mindset of looking and thinking. something it doesn’t feel right, or my body may not be working. Right. And so we have to reassure them. So I think, you know, pacify was born to meet both of those things, accessibility, and also empowering parents that this is working, and you’re doing well. Now, we certainly absolutely find issues, right? We definitely find issues with latch. That’s the beauty of the video, we find issues with engagement, people going back to work, you know, how do I start pumping? What do I do? How do I give this child a bottle? If I’m expressing milk? How do I do that? And so we we try to, you know, support parents all the way around when it comes to to their questions.


Jacqueline Kincer  13:13

Yeah, oh, that’s just incredible. And I find, you know, I think alphabet says lactation consultants find that there is that distrust of our bodies and doing something new and just not not being surrounded by breastfeeding. It’s not normalized. So how do we know when it’s going? Well, so so much of what we do is that reassurance that education, like you said, but of course, you see problems. And that actually leads me to the question I want to ask, which is, what are the main issues that you’re seeing among new parents? You know, I think one of the things that, that you do that’s really important is, maybe it was an Instagram message or something I received the other day, and, you know, someone said, it was like, 4:41am their time, you know, and they’re, they’re on there, right. And maybe they clicked on a hashtag. And that led them to my page or something. And, you know, they they found some support some information or that they were looking for, but I hear from a lot of a lot of breastfeeding parents, you know, they don’t want to wake their partner, because maybe that’s the person who has to wake up early to go to work the next day, or what have you, and they feel alone. And so they turn to their phones. And so I think there’s a lot of that feeling alone, and I’m sure the pandemic why No, the pandemic has not helped that as well. So, what are a lot of the issues you’re seeing, and have you seen things changing with the COVID 19? pandemic?


Melanie Silverman  14:36

Yes. So, thank you for asking. So, um, we see general lactation issue. So let me also be clear, I think it’s really important to say this, that pacifier is not a replacement for inpatient care, or in person cares what I should say, actually, and so we’re not replacing lactation consultants in hospitals. We’re not replacing lactation consultants in these WIC programs. We’re not really Placing lactation consultants in public health. We are an icing on a beautiful cake. And so our job really is to come in and to help to support the 24/7 nature of breastfeeding. Okay. And so some of the issues that we have and what’s really neat about being a video platform is Blach, right. I mean, you and I both know that, that that if you don’t have a latch, you don’t really have any breast milk. So you have to get that. So that’s probably number one. That is this latch. Right. And then from there, it’s a lot of nipple pain, and gorge meant returning to work and pumping, we do get questions about medication safety. So there’s, you know, it’s very much what you’re seeing. I mean, I read those Instagram, I actually, I see people struggling on Instagram, I can see it, I can see these parents writing in and wanting to know what they need to know and just needing a little reassurance, that little bump. And that is really what pacify provides. Now, let’s talk about COVID. Pre COVID, everybody was still anxious having a baby, it’s a very tough situation. Post COVID or during COVID. My gosh, I’m the amount of people who called crying. A lot of people cry when they talk to us. But the amount of people that entered in a video already bawling has increased exponentially. multiple providers have reached out to me we’ve had just more tougher clinical situations because the hospitals were discharging people so early. So we were dealt with we had an a lot of complicated things coming in a lot of anxiety. Just a lot of tears, we’ve had fathers call and say they have postpartum depression. It’s hard when you’re in that delivery room and everybody’s wearing masks, you know, multiple masks, three masks, and they’re pushing you out and you don’t get to see a lactation consultant, it’s just not the experience for those of you who deliver in hospitals. You know, I see these parents walking around. And I think they’re heroes. Delivering during a pandemic is really, it complicates your already very complicated birth experience and breastfeeding experience. So we have done our very best to support parents. The neat thing about passive by Jacqueline is you can stay on the phone as long as you want. So if somebody calls in and they need to talk to one of my lactation consultants for 45 minutes, we will stay, we actually encourage our lactation consultants to stay so there’s no little timer in the corner, they can call 50 times if they need when we built pacify back in 2014. We tried to set it up to really meet parents where they were and what they needed. And they don’t need a timer in the corner. And they need to be able to call the moment they have a question. And so that’s what we did.


Jacqueline Kincer  17:48

Oh, oh, I love that so much. You know, I when people book appointments with me, I put a there’s a time on there, right? I book a time slot. And of course, if I’m seeing multiple people, I have to cut it off at some point, right? But the The truth is, is that I don’t think I’ve ever kept an appointment to its originally planned time, right? Like we we go as long as you need and it’s okay, if I’m 10 minutes late to the next one, they’ll understand right? So I love that about you. And as someone who’s been on the other end of the patient side on telehealth platforms throughout this pandemic for numerous things for me, that little timer in the corner definitely gives me anxiety, it makes me feel like I can’t ask all the questions that I’d like. And I can kind of see my providers eyes darting to the timer impact to me, Oh, and there’s just this whole thing, right? And some of these apps will auto sign you off at a certain time. And it just is very, very disheartening. And I’ve been a provider on apps like that. I don’t do that anymore, because I would rather just do it through my own way where there isn’t that, you know, time limit, like you said, Gosh, 20 minutes may not be enough for a lot of people. So Well, I really thought it through right, you’ve taken the real world experience looked at a way that how can you augment that not try to replace something like you said, and then offer that different level of care that isn’t available somewhere else? And you’ve really thought it through? Like you’ve really done a good job of creating something for these breastfeeding families.


Melanie Silverman  19:31

That’s very kind of you to say, I do want to say one thing about like your private practice has I had a private practice just like you before pacify and absolutely to all those IBCs IBCLCs out there. Don’t sit there for four hours. I mean, that’s just making use of your time. Okay. The reality is what I want to tell you I’m passing by what’s interesting is that, you know, this is kind of a er situation for lactation, right. It’s like treat it, you know, treat them in Streatham, okay, that’s what they say. And that’s kind of what we say at Apple. by the average calls about 15 minutes. So that’s just kind of interesting, right? So when they call us when they call you or me in private practice, it was a whole situation, right? Like, right, sit there and like, fill out the forms. And can we touch the baby in the breast? And that can we, you know, hold the baby we have, you know, they, of course accept terms, there’s privacy issues, we have everything like that, but these are kind of one off questions, right. So they’re, they’re not as detailed as a a in person care. And so that’s why, you know, it’s interesting when people say, you know, how long am I going to be on the phone when I hire IBCLCs across the United States, and I say, we know that our average calls about 10 to 15 minutes, so it’s not gonna if you really, truly treat them and Streatham is different than private practice. And then can I just bring, I would just like to bring up one thing that I think I’m thinking about COVID, I just want to bring up you know, so much about when I, when I started, pacify was very focused on the patients, right, the the moms, the dads, the uncles, the aunts, everybody calls, pacify, by the way, it’s not just mothers calling, you know, everybody seems to call us, which is really kind of cool. But I do want to just take one quick moment to just talk about the people that are answering the calls, because they have stories to write. And so what’s really interesting is about who who signs up to take these calls, who has thrown themselves into this COVID situation with people who are lactating. And it’s a really neat fleet of lactation consults across the country, some of them have very young kids, and just need to kind of fill the time because they think their kids are cute, but they really need some professional time. And so they answer a couple calls, you know, a month to stay professionally engaged. And then there’s people who have teenage kids who may be working in the hospital full time, maybe they want to make a little extra money on nights and weekends. There’s other people who are retired, who just cannot stop Jacqueline, they just these people love their jobs, they’re built to be lactation consultants, and they, um, they just can’t stop. So they may travel all over the place. And just take a couple calls here and there just to stay engaged and to help parents and also to just make some money. And then, you know, the fourth group is people who may be ill, people who have health challenges that they are not allowed to be in the hospital, they just can’t physically. And what pacify does is provide jobs for IBCLCs, who really love the work have felt they’ve come to me quite depressed, because they haven’t been able to do what they want to do, because of some kind of a health situation, but passed by allows them to do it. And so I’ve really shifted my focus, I absolutely care about these parents who are calling in, but my focus has completely become all my fleet taking care of them, supporting them as much as possible, giving them as many patients as possible, and opportunities for professional growth. And so it’s it’s um, that’s a whole nother interesting story. I think just about this whole kind of ecosystem of pacifying what we do.


Jacqueline Kincer  23:01

Oh, yeah. Thank you so much for sharing that. Because it’s important, right? But it’s important that when if people are calling in that they know, kind of what they’re getting, you know, who’s who’s on the other side. And it’s not it’s not robots. It’s not people that that don’t can’t relate to you. So and I love that you shared that. There’s all these extended family members that are calling in as it that they’re looking for how can they support the breastfeeding person in their lives? And so they’re coming to you to ask about that


Melanie Silverman  23:34

rocked. Yes, I have actually I take calls on pacify sometimes because I don’t think it’s really nice to be able to support and manage my fleet of lactation cells without feeling what they feel. So I will sometimes take calls just feel what it feels like, oh my gosh, I’ve had grandmas, grandpas, aunts, uncles, cousins, sisters, everybody, best friends that are sitting with them. You know, this was actually really funny. Jacqueline, one time. This is a couple of weeks ago, I had a woman call in and I could see that her mother was sitting next to her. So she called and she asked me all these questions. And then she looked at her mother and the mother said, I told you that’s what the lactation consultants, say because she was a NICU nurse. And she knew so she said, so the grandmother said to me, she got into the video, she said, Melanie, the reason we call passed by today’s because my daughter and believe me, and you said exactly every single thing that I said so now maybe she’ll believe me about the baby. So it was a very cute moment between like two health care professionals and that was a grandma mom situation and they were very, very sweet. But you know, the, it we see a lot and I think that’s the I would hope that that’s a sign of the times that people around the person who has a baby are starting to you know, support more. We do get calls. A lot of fathers calling.


Jacqueline Kincer  24:56

Yeah, I see that too. I get alright Down followers on social media and they they’ll often book appointments for their partner, or mothers, like you said, so the baby’s grandmother that’s very common. And you know, I know that with, it’s great that you can do that on that video platform. Because so often when, because of the pandemic, people go to seek in person care, it’s like only one person is allowed, you know, just the patient. No, you know, other people, we can’t even sit in the waiting room, they’re sitting in the car. And like, that’s not a good way for people to get support, because they need everyone around them to understand how to support them in breastfeeding, and it’s emotionally and mentally taxing. For that person who’s just had a baby who’s struggling with breastfeeding, to then try and remember everything and re speak it to everyone around them. So if they can sit there on these video calls, and just hear it directly, if you want to talk about, you know, paste bottle feeding with someone right now, now, it’s not on that mom to show her husband or her mother, her father, whoever, right to how to do this, it’s already everyone’s on the same page. So I love that. And I would also love for you to talk about because you started to go to this point about who you hire, who’s in your fleet of lactation consultants. And it sounds like I feel like it’s sort of reading between the lines, because I can’t say I’ve called in to use a lactation consultant and pacify it wasn’t really wasn’t really something when I first started breastfeeding, but um, I think there were like two apps. And it was like tracking feedings and diapers. So a lot has happened in these last several years. But I hear from people I’m sure you hear from them to where they’re, they don’t feel listened to, or they have a lactation consultant or lactation nurse or someone who comes in shoves the baby on the boob, and then they can’t recreate that latch themselves at home, or once that person leaves. So when they come to you looking for that support, I know you’ve talked a lot about kind of the reassurance and emotional peace. But you know, what’s kind of the overall feel that you’re going for? It sounds like one of supports understanding, right, some really good counseling and communication skills there. But I think a lot of people have fear, sometimes they’ve had a bad experience somewhere along this train of seeking support. And then they kind of get this idea in their head, which I don’t blame them, where they’re like, well, that lactation consultant didn’t help me or that nurse in the hospital didn’t help me. So no one can help me, they’re all the same. But you’re doing something different. A lot of us are doing something different. So maybe just what’s it like someone logs on? They’ve got their issue? What’s happening, you know, in that communication between that provider and in that family, that parent?


Melanie Silverman  27:55

Well, you know, I will tell you that there’s 1000s of people waiting to work for pacify right now. Wow, that’s not even exaggeration. Me people, I think this is I think we’ve set up our team has set up a really safe space for lactation consultants, you know, we talk a lot about safe spaces for parents, right. And the way to do that what I have learned in the seven years, which I never thought I would like to manage as much as I do is that if we, we need to provide, first of all, we need to find talent, right? It’s about finding talent and and there are lactation consultants, and I know because I told you, I’ve listened to these podcasts. I know you talked about this and I cannot agree with you more if you have an experience with a medical provider, being a lactation consultant, uh, you know, Nurse Midwife of position and you don’t feel cared for fire them, get out of there, go find somebody else. There are good health care professionals that are empathetic and caring and love their jobs and they want to help, okay, and so what I’m looking for because remember, this telehealth environment, this video environment it create you have to be a certain kind of person. You have to smile and this is gonna sound a little crazy, but you kind of have to smile a little bit more you have to a little bit exaggerate your the way you move your hands or if you’re, you know, I have all these props, babies and bottles to show bottle pay speeding. I mean, you have to be very good in video, I think to be effective at tele lactation. And so there’s that but there’s also what I’m really looking for, to be honest with you is lactation consultants that are not going to judge you for your feeding decisions. That is for years before pacify on this red couch behind me I would see clients and one of the questions I asked on my intake form when I was I was working with picky eaters and food allergies and poor weight gain is Tell me about your breastfeeding experience. Jacqueline, they would cry. Their kid may be eight years old and not eating broccoli and that’s why they would hire me but when they recounted their bad lactation You know, experience, it may have been a bad lactation consultant, it may have been somebody that made them feel badly for using formula. I started to think that again before pacify, oh my gosh, these lactation consultants are causing harm to these parents. So I kind of that was a springboard for me when I started to hire lactation consultants that I refuse to put anybody on this network that makes parents feel guilty. And I’m very strict about this. I’ve interviewed people that have, basically the alphabet after their name, they are so educated, and I will not put them on the pacify network because they will make parents cry, I have no time or tolerance for that. And so the network, I am very strict about who I hire is just what I want. Because I’m looking for a certain kind of lactation consultants. And that’s what I say. And so the people that answer these calls, went through a rigorous interview, they probably didn’t even realize what I was asking them. Because I’ve had, you know, I’m not in the mood to, to to put anybody on pacify, who is going to make parents feel guilty. We get questions about weaning, we get questions about formula, and it is our job to put the parent feeding the child first. And so, of course, we want to extend breastfeeding, of course, we want to help initiate breastfeeding. You know, we have research studies to show that we are able to do that, but we really mental health has got to come first it has to come first. And so my lactation consultants are superb at teasing that out and supporting them the way they want. So they really need them. However they come into video. Like I said, sometimes they just come crying. Literally we pull up the video, and they are bawling, and they are poor saying I’m so sorry. I’m so sorry. And we just


Jacqueline Kincer  31:44

say yes. And and Can we all just take a moment to say that. I put it in my like when you can schedule an appointment with me like the confirmation email you get, I think there’s something in there. Maybe it’s more for home visits and video, I got to make sure it’s in the video one too. But like, apologies are not accepted. Please, please, women of the world stop apologizing for your feelings? Because, yeah, crying is very common. And it’s so funny. You know, I’ll have moms even say, Oh, I’m sure you see this all the time. And I’m like, Yeah, but that doesn’t minimize how you feel. Right? You’re sad, you’re struggling, you don’t have the support you need. And that is totally valid. I’m not here to tell you, you’re wrong for that. And it’s so sad to me that so many people come to us apologizing for that, right? So I love that you have this no tolerance policy for parents feeling judged. Because when we open that space up, then they feel safe to cry with us. And you’re creating that. So I just think that’s so valuable. I think beyond the tactical things that you can give them for breastfeeding, even just offering that as a service. That I mean, you can’t really put a price tag on that to have someone feel supported and seen and heard.


Melanie Silverman  33:02

And the other thing is, again, there’s no ulterior motive here. If people want to stop, we’re there to support if people want to keep going. We’re there to support. But the neat thing about these limitations that I say are more skilled than me for sure. Some of these people have taken almost 10,000 calls is that, you know, they’re able to really figure out if there’s a way to continue breastfeeding. Sometimes somebody calls and says, I want to wean, I’m done. I can’t take this anymore. I really don’t like my husband anymore. I don’t like anybody anymore. I got to get this. Right. Okay. You know, sometimes just saying, Tell me your story. Tell me what’s happened in the last several months, weeks days. And it’s very interesting. Sometimes. They say, Well, maybe I can start to pump. Maybe I don’t want the baby on the breast, in the My lactation and so on. So like, maybe Is that what you want to try? Do you want me to teach them how to do that? It’s a very slow, methodical, but caring empathy first, which I can hear in your voice. Do you do the same with your clients too? I just seen so many tears, Jacqueline, it just makes me I’ve seen so much trauma around breastfeeding and maybe the lack of care that I that they’ve gotten that I just have become very sensitive to it and I think a good way and so that’s why it makes sure that all the T shirts


Jacqueline Kincer  34:18

Oh, I love that. Yeah, empathy first. That’s that’s just incredible. Yeah, and, and you I know this is something that is important to you leading pacify the way you do. And I’m sure not just in who you hire, but who you serve. But I’d love for you to talk about diversity and what that looks like, through what you’re doing it pacified because I do find that you know, I have to recognize my bias as you know a woman that’s white and sis and pretty privileged and you know what I have access to what I have knowledge that I have access to and a lot of people don’t have that. And, you know, there there’s sometimes is a barrier there right with people trusting us with with care, too. So I would love for you to just talk about that. What are what are you doing there? And how are you ensuring that you’re able to meet the needs of a lot of different people?


Melanie Silverman  35:22

Well, first of all, let me just say this, I think it’s really important to explain how pacify is given and then why that diversity is so important. And so yeah, bypassed by anybody can go by it, download the app and pay it’s about $70 a month. The second way people get pacifies. It’s a baby shower gift, actually. So you can gift it. The third is public health, Medicaid and WIC we actually give pacify for free to that population through partnerships, okay, and that population is extraordinarily diverse. And so we felt from the very beginning, that we believed in having a diverse network, even though sadly, the lactation profession is not very diverse. There was a study that just came out in UCL CA, US LCA that talked about the number of black women who are IBCLCs, and it’s less than 5% of the population, but 12% of the population is African American, the United States. And so we try very hard to mimic what the United States looks like in our fleet. And so those all those kinds of partnerships that we have, we work with hospitals, and then employers as well, we just feel very strongly that when you connect with somebody who looks like you, similar, maybe religious you similar culture as you, there’s something that brings you into, it’s like being cared for by your family. And there’s something that eases people and makes people feel maybe calmer or cared for when you have that situation. And so we just felt from that perspective, it’s very important. And also, we we just, it’s so disturbing how not diverse the profession is, is that we started a scholarship in 2019, where we give each one of our state partners $1,000 scholarship, where we could take somebody because it is extraordinarily expensive, as you know, to take that IBCLC exam, it’s around maybe $700. And so we decided, you know, what we need to help to push people to become lactation consultants to diversify the network. So it’s our diversity and lactation consulting scholarship. And we just from the beginning, I mean, this is this is in 2014, we were thinking about this, because we just thought this is it’s important to to have a diverse network, to certainly care for parents, but also to make us better as a company and to make us think, in different ways and important ways and to just grow in a positive direction. So that’s kind of where we stand with all that,


Jacqueline Kincer  37:58

huh, yeah, that’s so, so important. And I love that you’re doing things to create opportunity for people not only to have more access to get care, but to equalize, you know, the providers that are out there by doing the scholarship. So that’s huge. I actually didn’t even know that. So thanks for sharing. Yeah, there’s just, there’s so much I did have a question for you. Because the way you work is, is a bit different than maybe you know, someone who’s going to be working with with someone in person and having all of that. You know, you mentioned kind of some of the big issues right latch, nipple pain, that kind of stuff that may come up when people seek help from you. What happens when someone on your network is suspecting or the parent knows that there’s a tongue tie or lip tie going on with the baby? How do you end up supporting those families? Because obviously, it’s video right? And, you know, I have my own answer to this and how I do that. So so what happens from that standpoint, when you’re like, you know, you’re kind of doing all the right things, but it’s just not really going well. Here’s what you think is going on? What’s next for people that call in to you?


Melanie Silverman  39:07

Right question. So what what so I’m so glad I explained the way that our our our business works and how you get passed by because we do a lot of partnerships, hospitals, public health, Medicaid programs, WIC, so we actually have close relationships with these people, where and we have protocols in place, you know, like I said, and I want to emphasize again, is we are not a replacement for in person care. Nine out of the 10 calls nine that half out of the 10 calls that come in to pacify our treatment students situations, Jacqueline, you could do these in your sleep at stuff that you and I learned, but you know, what, you know, point five out of 10% of the time, there’s a situation and so we have protocols to escalate that so my lactation consultants would come to me and say, Hey, I suspect this this may be a problem and we would escalate we will tell people always, always always we are not primary care physicians. We are not the medical home. So we are very our language is very much like referral Back to your doctor. If there’s, you know, let’s talk about postpartum depression, it’s real, it happens, and we need to address it and support it. Again, we have protocols in place to get those people help. And so we are able to help people also find local care if they need it. And again, it’s almost like we are not case managers, but my lactation consultants are so skilled in being kind of, I guess, for lack of better words like scrappy and thoughtful about like, care. And so they’re able to kind of help but really kind of know where they got the app, first is really important. And then they can kind of figure out where to support people from there. But we don’t we don’t, of course, don’t diagnose. It’s not what lactation consultants do. We, sometimes people may want to say, Can I show you the inside of their mouth, we it’s, it’s a little I don’t know, if you’ve had much success, you know, really kind of looking in that mouth and having somebody hold it and getting the baby’s freaking out and everything. But it’s really that something that a local lactation consultant should really care for. We are more general Lactation Support.


Jacqueline Kincer  41:04

Yeah, I love that. That’s such a great answer. Yeah, I just didn’t want anyone to think if they felt like they had something more complex, but they weren’t sure that they couldn’t come to you, or they’d sort of be like, you know, what, we don’t know what to do for you. So you have those protocols in place, you can help direct them and escalate that to get them that continued support. And, you know, I know for me, when I do video consults, you know, I have a way where, where we can look inside the baby’s mouth, and it’s, it’s hit or miss. But it’s not, you know, I always tell people, I’m not cutting the tie on video for eight. And I wouldn’t do that in person either. Because that’s not what I’m trained to do. But, but at least if I can see in there coupled with seeing what’s happening with breastfeeding, then I can tell you if it’s worthwhile to go visit someone else to get it addressed in person. Because I think that’s sometimes what people want, right? Like, do I need to go pay for this full on in person consultation, or do I not? And so it sounds like that’s really one of the other things that you offer, too, is sort of like this triage, you know, where you go, where do you go next? And you can really help them with that.


Melanie Silverman  42:11

I love that. No, I mean, that’s very smart that you just said that. Yeah, I mean, it’s a triage situation, and then we can, you know, we can help treat them we will. But, you know, again, I just, I think it’s so important that, you know, I can understand why lactation consultants in the, in the United States who don’t understand pacifier No Pass, I would be worried what are these people doing and who aren’t these lactation consultants, qualified, and that, you know, they’re not quacks on the shack, you know, on the corner, these are people, a lot of them 93% of them Jacqueline have a registered nurses, registered dietitians or medical doctors actually have this is kind of amazing. I have medical doctors who are IBCLCs, who like medicine, but love lactation. And I think they love it. It’s like the purest form. When I’ve thought about this, like, Why does an MD become an IBCLC? And I feel like some of the MD IBCLCs I’ve spoken to, it’s like they’ve described as like, the purest form of medicine, right? It’s like nature’s medicine, right. And so they just feel it’s a very pure experience to counsel a, you know, you’re not writing a prescription for antibiotics or something else. It’s giving breast milk to help the health of the mother, you know, the breastfeeding person who’s taking care of this person of this little baby, and also this baby. And so I don’t know, I just like to add that because I find that group, the MD IBCLCs. Fascinating.


Jacqueline Kincer  43:33

Oh, that is so cool. I love that you, you know, just thought about what what that motivation is what that drive is because we definitely, generally don’t make as much as empty. So some people be like, why would you want to do that? So I love I love that so much. I think you’ve given so much insight into what you do. And I just want everyone who’s listening to know like, there are different levels of support. I talked about this in one of my podcast episodes in terms of just certifications and credentials, right? Not everyone needs a full on IBCLC. Maybe you just need a CLC maybe you need a WIC peer counselor, maybe you need a La Leche League meeting. You know, maybe you need an MD like there’s all sorts of levels. And pacify just provides another part of that breastfeeding care continuum. And I’m so thankful that you came to share with us what that looks like. So if anybody’s ever heard about the app or thought about it, now you really have an idea of what it’s like. And I know that Melanie your hearts so big and with everything that you’re doing, and I can really tell that just from the way you talk about this company and what you’re doing there and it’s even so big that you decided to offer something really special for our listeners. So if you can tell us about that and I’ll put it in the show notes. So people don’t have to try. Don’t write this down. When you’re driving. Just check the show notes. You’re in a safe place. When she put the baby down,


Melanie Silverman  44:58

down Don’t do anything crazy. Yeah, here’s how here’s how it goes. So we actually created a code for everybody listening. pacifies runs about $70 a month. And that’s unlimited care from an IBCLC for 30 days 24/7. And just to put in perspective, you know, when I used to charge I charge $150 an hour. And so this is $70 a month, unlimited calls from your phone, and we’re offering a 20% discount using the code, ballistic. Breastfeeding that we wrote, is that right? I think that’s what we wrote. I have


Jacqueline Kincer  45:33

to look and make sure we have the correct one in the photo.


Melanie Silverman  45:35

I’m so sorry. This is this is not good that I’m messing up on this last part. Oh, no. I thought that I I was just looking at my notes. And then I thought, oh, my gosh, wait, what is the code? This is not good. Second, okay. But we I think we roll. Yeah, no, we, I will have to get back to you on that. But I think it’s, um, it was created. I didn’t write it down. And I’m so sorry. But I think it’s like, I thought it was holistic.


Jacqueline Kincer  46:04

Breastfeeding. Well, whatever it is the real code that works.


Melanie Silverman  46:09

Reena, I failed in this arena, we will put it in the shownotes. Everybody, I promise, it’ll be there.


Jacqueline Kincer  46:14

Yes, it’ll be all good. And if anybody has any issues, or anything, you’re welcome to contact me. I’m happy to make sure we got it all straightened out. And yeah, it’ll be accessible to anyone who’s listened here or read the show notes. And I just want to say thank you so much for your generosity, because I know that helps when people are feeling like, Oh, my goodness, I have just already maxed myself out here with all of the things for the baby clothing. I mean, diapers, like, it’s just it’s a lot for families. And what you’re doing is such a huge value for for what people have to invest. So I just think it’s phenomenal.


Melanie Silverman  46:55

I found the code. Oh, good. Hold yourself together. I’m so sorry. This is very embarrassing, but it’s holistic lactation is oh, there we go. So see, that’s easy to remember.


Jacqueline Kincer  47:04

Like, yes,


Melanie Silverman  47:06

I hope that that will work. Yes. Oh, listen, no, it will work. But listen, lactation is the code for 20% off. Thank you all for your patience as I scrambled to find,


Jacqueline Kincer  47:15

oh, gosh, you know, that’s okay. Everybody here is probably got some Mom Brain to some extent. My kids are eight and five. And I still have Mom Brain. I forget where I park every time I park my car. And if I have my kids with me, they remember, like, I’m like, I only think we parked here. And they’re like, yeah, the cars right over there, Mommy. And I’m like, How did you know, I had no idea where I left it when we got


Melanie Silverman  47:39

I know, my kids are 14 and 15. And I found a fork in the pen drawer yesterday. And I’m thinking I put that there. It could be them because you know, the teenagers like oh, yeah, with the brain. So we’re all kind of out of it here. But thank you for your patience. Everybody. Holistic lactation is the code. And I really thank you so much. This has been absolutely delightful. You are really, you are really a special IBCLC. And I’ll tell you, I bet you anything your patients. Your parents love you. I can tell.


Jacqueline Kincer  48:09

Well, the ones that give me feedback, say they love me and the other ones I haven’t heard from.


Melanie Silverman  48:14

Well, I have a sense. I have a sense that you know, they probably love you most. Ah, thank you.


Jacqueline Kincer  48:21

Thanks. No, thank you. Thank you for being on the show. It’s been such a delight and pleasure and your personality really shines through and I’m sure it shines through everything you do and pacify. So I really appreciate you sharing so much and your expertise with us today.


Jacqueline Kincer  48:38

Thank you. Did you know Most moms stopped breastfeeding in the first month postpartum. I believe succeeding at breastfeeding means having the right mindset. In fact, studies show that the number one factor that determines breastfeeding success is commitment. Which is why I’ve created my incredible audio download of breastfeeding affirmations where I give you actionable mantras so you can breastfeed your baby with confidence and peace of mind. And best of all, it’s free. To get access to this audio and PDF. Simply visit holistic And you can get started right now.



Melanie Silverman, Chief Clinical Officer at Pacify, joins us today to discuss her background and the ways her company meets the needs of breastfeeding families. While not a replacement for in-person care, Pacify offers parents 24/7 support for breastfeeding questions and help. While Pacify is not a replacement for in-person care or working with complex issues like tongue tie, it augments breastfeeding medicine with its accessibility to families across the US.

In this episode you’ll hear:

  • What Pacify does for new parents, all over the United States.
  • Why Pacify sis o important to new parents–breastfeeding can be an amazing way that new parents can improve their own health and the health of their babies. 
  • The main issues we see among new parents — also address, that they feel alone (especially during COVID-19!) and are wondering whether they are doing this “breastfeeding thing” correctly!
  • Breastfeeding can be an incredible equalizer. The vast majority of new parents struggle with the same questions about breastfeeding.
  • Pacify hears from non-birthing partners, grandparents, aunts, uncles and cousins and others who call in for help.
  • We really need to listen first, rather than come in with our own agenda and provide care without judgement.
  • Diversity among IBCLCs — why it matters and ways that to address it